INVESTIGATOR'S DESCRIPTION: The research is part of a larger goal to understand the role of culture on the experience of heart disease, depression, and their co-morbidity. The research begins with a cultural investigation of post-socialism in eastern Germany, but will culminate in an understanding of illness as a meaningful experience in a context of rapid social change. Research suggests that heart disease (and heart disease co-morbid with depression) is sensitive to biologic and psychosocial variables, but few studies have investigated the role of culture in heart disease, or its co-morbid state. This work builds on research into culture and hypertension, and culture and depression, to fill a gap in our understanding of the cultural processes at work in the expression of heart disease, but adds a new dimension by exploring co-morbidity. The research will take place in eastern Germany, where individuals are at increased risk to both conditions since 1989. Research aims include: 1) a community-based cultural study of the political-economic transition; 2) a community-based cultural study of cardiac and mental health; and 3) a clinic- or hospital based appraisal of cultural factors among patients expressing: a) heart disease; or, b) co-morbid heart disease and depression. Data sources will include: ethnographic interviews of post-socialism; idioms of distress, explanatory models, illness narratives, and semantic illness networks for heart disease and depression; a cultural consonance measure; measures for depression; demographics; and, local health statistics.